Effect of Treatment Modality on Mobility and Quality of Life in Unstable Intertrochanteric Fractures

Abstract

ABSTRACT Purpose: The aim of the study was to investigate mobility and quality of life in patients who underwent osteosynthesis with proximal femoral nail (PFN), or arthroplasty for unstable intertrochanteric fractures. Methods: Treatment outcomes of 117 patients (76 Female/41 Male) who were treated with PFN (Group 1, n=66), hemiarthroplasty (Group 2, n=42), or total hip arthroplasty (Group 3, n=9) between 2008 and 2014 were retrospectively evaluated. The mobility of the patients was evaluated with the Palmer and Parker mobility score, and the quality of life was evaluated with the Barthel quality of life index. Results: The mean ages in the groups were 83.51 (range, 75-97) years, 84.72 (range, 75-109) years, and 83.37 (range, 75-94) years; respectively. The mean follow-up periods were 23.26 (range, 3-43.9) months, 19.24 (range, 3-38) months, and 20.1 (range, 3-40) months; respectively. There was no statistically significant difference between the 3 groups in terms of age and follow-up time (p>0.05). Palmer-Parker mobility scores were 6.23 for Group 1, 3.68 for Group 2, and 4.22 for Group 3. Barthel Indexes were 68.73 for Group 1, 37.75 for Group 2, and 52.77 for Group 3. Group 1 had a statistically significantly higher Palmer-Parker mobility and Barthel Index score than Group 2 and Group 3 (p<0.001). Conclusion: We concluded that osteosynthesis with PFN was more advantageous than hemiarthroplasty or total hip arthroplasty in terms of mobilization and quality of life in patients who were operated on for unstable intertrochanteric fracture.